Monday, February 15, 2010

More Ideas From the Right

I believe that listening to ideas from the right side of the aisle is a good idea, and I certainly hope that the bipartisan healthcare summit to be held on February 25th does not degenerate into political posturing and name-calling by either party. Not all ideas put forth by either Democrats or Republicans are necessarily born without blemish, but almost all deserve some consideration.
One good idea from the right is to make health insurance available across state lines. Here is a true life example:
When Barbara retired, she lost the health insurance that came with her job. When she applied for private coverage, it was denied because she was taking two blood pressure medicines; if she had been taking only one, she could have got it. So she opted for the high-risk coverage offered by the state of California, at a cost of almost $900 per month; upon moving to Pennsylvania, the same coverage was $240 per month. Interestingly, the price of the medicines in Pennsylvania was slightly less than it was in California even though they were identical. Go figure.
The right has also pointed out that if you insure 40 million more people, you are going to need a lot more doctors and nurses. Their solution is to phase in reform gradually; let the presently uninsured wait and wait and... That might work, but I see at least two problems: people would continue to die for lack of insurance, and there is no reason to assume that the training of medical personnel would increase along with the patient load. Nevertheless, the point is well taken, and needs to be addressed.
I suggest that an incentive is needed; perhaps generous scholarships could be available for student MDs and RNs. It is also worth considering extra allowances for those willing to serve in low density areas for, say, five years after graduation.
Also the value of nurse practitioners as gateways to the system should not be overlooked, particularly in rural areas. Training NPs is faster and far less expensive than training new MDs. An emphasis on such training would cut years off the readiness of the healthcare system to absorb new patients.
Also on the Republicans’ agenda is a discussion of cost control for Medicaid, Medicare and Social Security. I shall discuss those at a later time. Stay tuned.